| Dr Psychologist Llc | |
|
26829 Tanic Dr Ste 101 Wesley Chapel FL 33544-4612 | |
| (813) 219-0152 | |
| Not Available |
| Full Name | Dr Psychologist Llc |
|---|---|
| Speciality | Psychologist |
| Location | 26829 Tanic Dr Ste 101, Wesley Chapel, Florida |
| Authorized Official Name and Position | Jessica Pena Morales (OWNER) |
| Authorized Official Contact | 8132190152 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Psychologist Llc 2870 Satilla Loop Odessa FL 33556-2736 Ph: (813) 219-0152 | Dr Psychologist Llc 26829 Tanic Dr Ste 101 Wesley Chapel FL 33544-4612 Ph: (813) 219-0152 |
| NPI Number | 1942952312 |
|---|---|
| Provider Enumeration Date | 01/26/2022 |
| Last Update Date | 01/04/2023 |
| Certification Date | 01/04/2023 |
| Medicare PECOS PAC ID | 9830544188 |
|---|---|
| Medicare Enrollment ID | O20231012000369 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942952312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jessica J Pena Morales |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639318819 PECOS PAC ID: 7517094816 Enrollment ID: I20210910002996 |
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